Individual
MONTANA BORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2617 GENERAL PERSHING BLVD, OKLAHOMA CITY, OK 73107-6437
(650) 946-7773
Mailing address
PO BOX 12978, OKLAHOMA CITY, OK 73157-2978
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/13/2019
Last updated
11/19/2021
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